# Non-accidental Trauma as an Example of an Underestimated Problem in Pediatrics: Maltreated Child Syndrome and Shaken Baby Syndrome

## TL;DR

This paper highlights the under-recognized issue of non-accidental trauma in children, focusing on maltreated child syndrome and shaken baby syndrome.

## Contribution

The paper emphasizes the importance of recognizing and addressing non-accidental trauma in pediatrics through a case study.

## Key findings

- Non-accidental trauma can present with neurological symptoms and multiple injuries at different healing stages.
- A case of a two-month-old infant showed signs consistent with shaken baby syndrome and maltreated child syndrome.
- Medical staff play a critical role in identifying abuse and preventing long-term psychosocial harm.

## Abstract

Injuries, including both accidental and non-accidental trauma, represent a common reason for hospitalization in the pediatric population. The impact of violence in the caregiver-child relationship is an important and often underestimated problem in pediatrics. Child abuse can present itself in various forms, including both psychological and physical manifestations. This study details the maltreated child syndrome and the shaken baby syndrome, also known as abusive head trauma. Non-accidental trauma presents with a broad spectrum of neurological symptoms, along with multiple injuries at different stages of healing and potential indicators of shaking. A two-month-old male infant presented with body spasms, subsequently accompanied by muscle flaccidity, following an accident of unclear mechanism. Imaging studies revealed bilateral subdural hematohygroma with acute hemorrhage, multiple fractures in various stages of healing, and retinal hemorrhage. Clinical, psychological, and social findings were consistent with shaken baby syndrome and maltreated child syndrome, suggesting non-accidental trauma. Beyond the current injuries, it is significant to be aware of the long-term effects of violence, particularly psychological and social aspects related to neurological damage. The role of medical staff is not only to provide medical help but also to ensure the child’s safety and prevent a negative impact on their psychosocial development. Knowing how to recognize the signs of child abuse is relevant.